Healthcare Provider Details

I. General information

NPI: 1598628687
Provider Name (Legal Business Name): DAWN MARIE MILLS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2025
Last Update Date: 12/05/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42 SIMS ST STE 16
DICKINSON ND
58601-5116
US

IV. Provider business mailing address

3150 LAKEVIEW DR
DICKINSON ND
58601-7208
US

V. Phone/Fax

Practice location:
  • Phone: 701-504-9801
  • Fax:
Mailing address:
  • Phone: 701-504-9801
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number21103
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: